Application of Dexmedetomidine Anesthesia for Fiberoptic Bronchoscopy with a Target-controlled Infusion of Propofol　P. R. China_West China Medical Journal

Authors：

LI Wei , LIU Wenzhi , ZHU Yuehao , GAO Lunming , LI Lihua , CHENG Jun , TAO Guanghua.

Department of Anesthesiology, Chinese Traditional and Western Medicine Hospital, Panzhihua University, Panzhihua, Sichuan 617000,;

Corresponding author：

Keywords：

右美托咪定; 丙泊酚; 靶控输注; 纤维支气管镜检查

DOI：

10.7507/1002-0179.20130123

Video：

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目的　观察右美托咪啶复合丙泊酚靶控静脉麻醉在纤维支气管镜检查术中的麻醉效果。方法　2010年12月－2012年4月，将60例行纤维支气管镜检查术的患者随机分为丙泊酚麻醉组（对照组）和右美托咪啶复合丙泊酚麻醉组（观察组），每组各30例。观察记录不同时点平均动脉压（MAP）、心率、呼吸次数（RR）、脉搏血氧饱和度（SpO2），镇静评分、手术时间、苏醒时间、丙泊酚总用量、不良反应发生率及患者满意度。结果　所有患者均能顺利完成操作，诱导入睡后观察组MAP、心率下降（P＜0.05），丙泊酚总用量、不良反应发生率均少于对照组（P＜0.05），镇静评分优于对照组（P＜0.05）；两组RR、SpO2、苏醒时间、手术时间及患者满意度差异无统计学意义（P＞0.05）。结论　右美托咪定复合丙泊酚靶控输注适用于纤维支气管镜检查术麻醉，是一种更加安全有效的麻醉方法。

Citation： LI Wei,LIU Wenzhi,ZHU Yuehao,GAO Lunming,LI Lihua,CHENG Jun,TAO Guanghua.. Application of Dexmedetomidine Anesthesia for Fiberoptic Bronchoscopy with a Target-controlled Infusion of Propofol　P. R. China. West China Medical Journal, 2013, 28(3): 387-390. doi: 10.7507/1002-0179.20130123 Copy

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2.	Bergese SD, Candiotti KA, Bokesch PM, et al. A phaseⅢb, randomized, double-blind, placebo-controlled, multicenter study evaluating the safety and efficacy of dexmedetomidine for sedation during awake fiberoptic intubation[J]. Am J Ther, 2010, 17(6): 586-595.
3.	Patel A, Davidson M, Tran MC, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy[J]. Anesth Analg, 2010, 111(4): 1004-1010.
4.	胡宪文, 张野, 孔令锁, 等. 不同剂量右美托咪啶抑制气管插管诱发患者心血管反应效应的比较[J]. 中华麻醉学杂志, 2010, 30(11): 1304-1306.
5.	林生, 倪淑芹, 孙东秀, 等. 右美托咪啶-异丙酚-芬太尼复合麻醉对颈椎手术病人体感诱发电位及运动诱发电位的影响[J]. 中华麻醉学杂志, 2010, 30(11): 1284-1286.
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10.	孙捷豪, 韩宁, 吴秀英. 右美托咪啶用于全身麻醉的随机对照试验的Meta分析[J]. 中国循证医学杂志, 2008, 8(9): 773-780.
11.	Al-Zaben KR, Qudaisat IY, Al-Ghanem SM, et al. Intraoperative administration of dexmedetomidine reduces the analgesic requirements for children undergoing hypospadius surgery[J]. Eur J Anaesthesiol, 2010, 27(3): 247-252.
12.	Lin TF, Yeh YC, Lin FS, et al. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia[J]. Br J Anaesth, 2009, 102(1): 117-122.
13.	Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. their pharmacology and therapeutic role[J]. Anaesthesia, 1999, 54(2): 146-165.
14.	Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. Their pharmacology and therapeutic role[J]. Anaesthesia, 1999, 54(2): 146-165.
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16.	Jalowiecki P, Rudner R, Gonciarz M, et al. Sole use of dexmedetomidine has limited utility for conscious sedation during outpatient colonoscopy[J]. Anesthesiology, 2005, 103(2): 269-273.
17.	Lam SW, Alexander E. Dexmedetomidine use in critical care[J]. AACN Adv Crit Care, 2008, 19(2): 113-120.
18.	Abouzgheib W, Littman J, Pratter M, et al. Efficacy and safety ofdexmedetomidine during bronchoscopy in patients with moderate to severe COPD or emphysema[J]. J Bronehol, 2007, 14(4): 233-236.
19.	Wiklund RA. Fentanyl or dexmedetomidine combined with desflurane for bariatric surgery[J]. Survey Anesthesiol, 2007, 51(2): 77.
20.	Hofer RE, Sprung J, Sarr MG, et al. Anesthesia for a patient with morbid obesity using dexmedetomidine without narcotics[J]. Can J Anaesth, 2005, 52(2): 176-180.
21.	Ramsay MA, Saha D, Hebeler RF. Tracheal resection in the morbidly obese patient: the role of dexmedetomidine[J]. J Clin Anesth, 2006, 18(6): 452-454.
22.	王克民, 孙艳红, 侯永强. 盐酸右美托咪定用于重症监护患者镇静及镇痛的临床观察[J]. 河南科技大学学报·医学版, 2011, 29(4): 267-271.

1. 　Rutkowska K, Knapik P, Misiolek H. The effect of dexmedetomidine sedation on brachial plexus block in patients with end-stage renal disease[J]. Eur J Anaesthesiol, 2009, 26(10): 851-855.
2. 　Bergese SD, Candiotti KA, Bokesch PM, et al. A phaseⅢb, randomized, double-blind, placebo-controlled, multicenter study evaluating the safety and efficacy of dexmedetomidine for sedation during awake fiberoptic intubation[J]. Am J Ther, 2010, 17(6): 586-595.
3. 　Patel A, Davidson M, Tran MC, et al. Dexmedetomidine infusion for analgesia and prevention of emergence agitation in children with obstructive sleep apnea syndrome undergoing tonsillectomy and adenoidectomy[J]. Anesth Analg, 2010, 111(4): 1004-1010.
4. 　胡宪文, 张野, 孔令锁, 等. 不同剂量右美托咪啶抑制气管插管诱发患者心血管反应效应的比较[J]. 中华麻醉学杂志, 2010, 30(11): 1304-1306.
5. 　林生, 倪淑芹, 孙东秀, 等. 右美托咪啶-异丙酚-芬太尼复合麻醉对颈椎手术病人体感诱发电位及运动诱发电位的影响[J]. 中华麻醉学杂志, 2010, 30(11): 1284-1286.
6. 　Dutta S, Karol MD, Cohen T, et al. Effect of dexmedetomidine on propofol requirements in healthy subjects[J]. J Pharm Sci, 2001, 90(2): 172-181.
7. 　苑进革, 陈永学, 赵森波, 等. 右美托咪定注射液的临床应用进展[J]. 山东医药, 2012, 52(44): 100-103.
8. 　Szumita PM, Baroletti SA, Ke AE, et al. Sedation and analgesia in the intensive care unit: evaluating the role of dexmedetomidine[J]. Am Health Syst Pharm, 2007, 64(1): 37-44.
9. 　李民, 张利萍, 吴新民. 右美托咪啶在临床麻醉中应用的研究进展[J]. 中国临床药理学杂志, 2007, 23(6): 466-470.
10. 　孙捷豪, 韩宁, 吴秀英. 右美托咪啶用于全身麻醉的随机对照试验的Meta分析[J]. 中国循证医学杂志, 2008, 8(9): 773-780.
11. 　Al-Zaben KR, Qudaisat IY, Al-Ghanem SM, et al. Intraoperative administration of dexmedetomidine reduces the analgesic requirements for children undergoing hypospadius surgery[J]. Eur J Anaesthesiol, 2010, 27(3): 247-252.
12. 　Lin TF, Yeh YC, Lin FS, et al. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia[J]. Br J Anaesth, 2009, 102(1): 117-122.
13. 　Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. their pharmacology and therapeutic role[J]. Anaesthesia, 1999, 54(2): 146-165.
14. 　Khan ZP, Ferguson CN, Jones RM. Alpha-2 and imidazoline receptor agonists. Their pharmacology and therapeutic role[J]. Anaesthesia, 1999, 54(2): 146-165.
15. 　Hall JE, Uhrich TD, Barney JA, et al. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions[J]. Anesth Analg, 2000, 90(3): 699-705.
16. 　Jalowiecki P, Rudner R, Gonciarz M, et al. Sole use of dexmedetomidine has limited utility for conscious sedation during outpatient colonoscopy[J]. Anesthesiology, 2005, 103(2): 269-273.
17. 　Lam SW, Alexander E. Dexmedetomidine use in critical care[J]. AACN Adv Crit Care, 2008, 19(2): 113-120.
18. 　Abouzgheib W, Littman J, Pratter M, et al. Efficacy and safety ofdexmedetomidine during bronchoscopy in patients with moderate to severe COPD or emphysema[J]. J Bronehol, 2007, 14(4): 233-236.
19. 　Wiklund RA. Fentanyl or dexmedetomidine combined with desflurane for bariatric surgery[J]. Survey Anesthesiol, 2007, 51(2): 77.
20. 　Hofer RE, Sprung J, Sarr MG, et al. Anesthesia for a patient with morbid obesity using dexmedetomidine without narcotics[J]. Can J Anaesth, 2005, 52(2): 176-180.
21. 　Ramsay MA, Saha D, Hebeler RF. Tracheal resection in the morbidly obese patient: the role of dexmedetomidine[J]. J Clin Anesth, 2006, 18(6): 452-454.
22. 　王克民, 孙艳红, 侯永强. 盐酸右美托咪定用于重症监护患者镇静及镇痛的临床观察[J]. 河南科技大学学报·医学版, 2011, 29(4): 267-271.

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Application of Dexmedetomidine Anesthesia for Fiberoptic Bronchoscopy with a Target-controlled Infusion of Propofol　P. R. China